Assessment of benefits of substance abuse treatments has focused mainly on abstinence from or reduction in substance use. However, the benefits of treatment may go beyond substance abuse outcomes and include improvement in health, social, and vocational domains. This study used data from the Services Research Outcomes Study (SROS) (1) to examine benefits of substance abuse treatments in a number of domains. The SROS interviewed a representative sample of 1,799 clients who received care in 99 treatment facilities across the United States during the 12-month period ending August 31, 1990. Treatment modality, substance abuse outcomes, and perceived benefits of treatment in other domains were assessed five years after the index treatment by in-person interviews with clients.

When patterns of substance use in the five-year periods before and after the index treatment were compared, only 19 percent of the clients reported abstinence from alcohol and drugs at follow-up, and 35 percent reported abstinence or reduction in use (2). However, more than half of the clients reported that drug abuse treatment had improved their health; helped them with their emotional, nervous, or mental health problems; helped them with planning their future; and improved their family relationships (F1).

Some differences were noted across treatment modalities in the perceived benefits of treatment. Clients in outpatient drug-free programs were less likely to report that treatment improved their health than those in inpatient, residential, or methadone programs (53 percent compared with 70 percent). Also, clients in methadone programs were less likely than those in the other three types of programs to report that treatment helped with emotional, nervous, or mental health problems (45 percent compared with 60 percent) or with planning their future (34 percent compared with 60 percent). However, more striking than these differences were the similarities across treatment modalities. Also of note was the consistent positive association of the perceived benefits in almost all domains with abstinence and reduction in substance use. It should be noted, however, that the SROS data were based on self-reports, not objective measures, and that the study was a naturalistic one, not a randomized clinical trial. Therefore, results should be interpreted with caution.

This research was supported in part by grant K01-MH-01754 from the National Institute of Mental Health.

Dr. Mojtabai is affiliated with the department of psychiatry at Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute in New York City. Send correspondence to him at 2600 Netherland Avenue, Apartment 805, Bronx, New York 10463 (e-mail, rm322@columbia.edu). Harold A. Pincus, M.D., and Terri L. Tanielian, M.A., are editors of this column.